| 1. |
- Brisman, Jonas, 1954, et al.
(author)
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Spirometric reference equations for Swedish adults
- 2017
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In: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961. ; 37:6, s. 640-645
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Journal article (peer-reviewed)abstract
- New spirometric reference equations for Swedish adults are required. Three different older sets of reference equations clinically used in Sweden have various drawbacks and the recently published 'The Global Lung Function 2012 (GLI) equations' have been shown not to be adequate for Swedish normal, healthy non-smokers. We have recently concluded that a piecewise linear model presented by Lubinski and Golczewski accurately describes the distribution of spirometric variables in a large Swedish random population sample. This piecewise linear model also offers the important advantage of implementing easily physiologically interpretable coefficients. The present study aimed at presenting piecewise linear reference equations for Swedish adults based on a random population sample of 6685 individuals aged 25-75years. Predicted normal values by the piecewise linear reference equations and lower limit normal (LLN) were compared with the three reference equations frequently used clinically in Sweden and the GLI equations. We found predicted normal values according to the present piecewise linear reference equations close to 100% predicted normal as expected, whereas the other equations either overestimated or underestimated normal subjects. Concerning LLN, the present equations, i.e. 1.645 x RSD, showed the least deviation from the expected 5% and, e.g., the GLI equations systematically identified too few subjects below LLN. We conclude that the present piecewise linear reference equations, based on a relatively large general population sample, ought to be considered for clinical use in Sweden. Application of 1.645 x RSD below predicted value gave an acceptably accurate LLN.
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| 2. |
- Carlsen, Hanne Krage, et al.
(author)
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Exposure to traffic and lung function in adults: A general population cohort study
- 2015
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In: BMJ Open. - : BMJ. - 2044-6055. ; 5:6
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Journal article (peer-reviewed)abstract
- Objectives: To investigate the association between living near dense traffic and lung function in a cohort of adults from a single urban region. Design: Cross-sectional results from a cohort study. Setting: The adult-onset asthma and exhaled nitric oxide (ADONIX) cohort, sampled during 2001-2008 in Gothenburg, Sweden. Exposure was expressed as the distance from participants' residential address to the nearest road with dense traffic (>10 000 vehicles per day) or very dense traffic (>30 000 vehicles per day). The exposure categories were: low (>500 m; reference), medium (75-500 m) or high (<75 m). Participants: The source population was a population-based cohort of adults (n=6153). The study population included 5441 participants of European descent with good quality spirometry and information about all outcomes and covariates. Outcome measures: Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were measured at a clinical examination. The association with exposure was examined using linear regression adjusting for age, gender, body mass index, smoking status and education in all participants and stratified by sex, smoking status and respiratory health status. Results: We identified a significant dose-response trend between exposure category and FEV1 (p=0.03) and borderline significant trend for FVC (p=0.06) after adjusting for covariates. High exposure was associated with lower FEV1 (-1.0%, 95% CI -2.5% to 0.5%) and lower FVC (-0.9%, 95% CI -2.2% to 0.4%). The effect appeared to be stronger in women. In highly exposed individuals with current asthma or chronic obstructive pulmonary disease, FVC was lower (-4.5%, 95% CI -8.8% to -0.1%). Conclusions: High traffic exposure at the residential address was associated with lower than predicted FEV1 and FVC lung function compared with living further away in a large general population cohort. There were particular effects on women and individuals with obstructive disease.
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| 3. |
- Fell, A. K. M., et al.
(author)
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Exposure to second-hand tobacco smoke and respiratory symptoms in non-smoking adults: cross-sectional data from the general population of Telemark, Norway
- 2018
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In: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 18
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Journal article (peer-reviewed)abstract
- Background: In Norway, data on the association between second-hand tobacco smoke (SHS) exposure at home and respiratory symptoms in adults are limited. Methods: We assessed the association between self-reported exposure to SHS and the prevalence of respiratory symptoms among never-smokers aged 16 to 50 years from the general population who were included in a cross-sectional population-based study in Telemark County, Norway. Logistic regression analysis was used to estimate the odds ratios of symptoms among 8850 never-smokers who provided an affirmative response to questions regarding SHS; 504 (5.7%) of these reported that they lived in a home with daily or occasional indoor smoking. Results: Productive cough and nocturnal dyspnoea were statistically associated with daily SHS exposure (ORs 1.5 [95% CI 1.04-2.0] and 1.8 [1.2-2.7], respectively). In analyses stratified by gender, nocturnal dyspnoea was associated with SHS among women (OR 1.8 [1.1-3.1]), but not among men (OR 0.93 [0.49-1.8]). Symptoms were not associated with occasional SHS exposure in the entire group, but infrequent exposure among men only was associated with increased prevalence of chronic cough; (OR 1.6; [1.04-2.6]) and was negatively associated with wheeze; (OR 0.44 [0.21-0.92)]. Conclusions: Daily SHS exposure in private homes was associated with productive cough and nocturnal dyspnoea. Our results suggest that preventive measures may be needed to reduce the respiratory effects of SHS at home.
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| 4. |
- Fredriksson, Sofie, 1983, et al.
(author)
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Preschool teachers have an increased risk of hearing-related symptoms and report more occupational noise exposure compared to randomly selected women
- 2016
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In: Occupational Health: Think Globally, Act Locally, EPICOH 2016, September 4–7, 2016, Barcelona, Spain. Occupational & Environmental Medicine. ; 73:A191
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Conference paper (other academic/artistic)abstract
- Noise-induced hearing disorder has been thoroughly studied among workers in industry-like settings, but less so in female-dominated occupations. In Sweden, noise-related occupational disease among women are reported most frequently in the education sector. We analysed questionnaires from 4,932 women with preschool teacher’s degree who have worked in preschool compared to 5,065 randomly selected women without preschool work-history (response rate 51% vs. 38%). The age range was 24–71 in both cohorts (mean 46 [SD 11] among preschool teachers and 51 [11] among controls). Prevalence and prevalence ratio in age-strata and Mantel-Haenszel pooled risk were calculated for hearing-related symptoms. Noise exposure was compared between the cohorts. A 5% level of significance was applied. Occupational noise exposure and noise annoyance were significantly more common among teachers than controls: 75% vs.31% and 69% vs.26%, respectively. Still, significantly fewer teachers used hearing protection: 3% vs. 4%. Prevalence of hearing-related symptoms was much higher among teachers than controls: sound-induced auditory fatigue (71% [95% CI: 70–72] vs. 31% [30–32]), difficulty perceiving speech (46% [45–47] vs. 26% [25–27] and hyperacusis (38% [37–39] vs. 18% [17–19] and slightly higher for hearing loss (19% [18–20] vs. 17% [6–18] and tinnitus (19% [18–20] vs. 15% [14–16]. Teachers had a twofold risk of sound-induced auditory fatigue (PR-MH 2.2 [95% CI: 2.1–2.3] and hyperacusis (PR-MH 2.1 [1.9–2.2] compared to controls, when adjusted for age. The risk was also increased for difficulty perceiving speech (PR-MH 1.8 [1.7–1.9], tinnitus (PR-MH 1.4 [1.3–1.6] and hearing loss (PR-MH 1.4 [1.3–1.5]. Mean age of onset was significantly lower among teachers for all symptoms, except for hyperacusis (p = 0.902). Leisure-noise was significantly more common among controls. Family history of hearing loss did not differ (p = 0.411). The study is the first to show that preschool teachers have an increased risk of hearing-related symptoms, which may be caused by the work environment.
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| 5. |
- Fredriksson, Sofie, 1983, et al.
(author)
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Working in preschool increases the risk of hearing-related symptoms: a cohort study among Swedish women
- 2019
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 92:8, s. 1179-90
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Journal article (peer-reviewed)abstract
- © 2019, The Author(s). Purpose: To assess whether working in preschools increases the risk of hearing-related symptoms and whether age, occupational noise, and stressful working conditions affect the risk. Methods: Questionnaire data on hearing-related symptoms were analysed in women aged 24–65 (4718 preschool teachers, and 4122 randomly selected general population controls). Prevalence and risk ratio (RR) of self-reported hearing loss, tinnitus, difficulty perceiving speech, hyperacusis and sound-induced auditory fatigue were assessed by comparing the cohorts in relation to age and self-reported occupational noise and stressful working conditions (effort–reward imbalance and emotional demands). RR was calculated using log-binomial regression models adjusted for age, education, income, smoking, hearing protection, and leisure noise. Incidence rates and incidence rate ratios (IRR) were calculated for retrospectively reported onset of all symptoms except sound-induced auditory fatigue. Results: Compared to the controls, preschool teachers had overall more than twofold RR of sound-induced auditory fatigue (RR 2.4, 95% confidence interval 2.2–2.5) and hyperacusis (RR 2.3, 2.1–2.5) and almost twofold for difficulty perceiving speech (RR 1.9, 1.7–2.0). Preschool teachers had a threefold IRR of hyperacusis (IRR 3.1, 2.8–3.4) and twofold for difficulty perceiving speech (IRR 2.4, 2.2–2.6). Significantly although slightly less increased RR and IRR were observed for hearing loss and tinnitus. RR and IRR were generally still increased for preschool teachers when stratified by age and occupational exposure to noise and stress. Conclusions: This large cohort study showed that working as preschool teacher increases the risk of self-reported hearing-related symptoms, indicating a need of preventative measures.
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| 6. |
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| 7. |
- Grimby-Ekman, Anna, 1967, et al.
(author)
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Pain could negatively affect school grades - Swedish middle school students with low school grades most affected
- 2018
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13
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Journal article (peer-reviewed)abstract
- © 2018 Grimby-Ekman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Recurrent headache, abdominal and musculoskeletal pain are common in adolescents and it is therefore important to understand their impact on the transitional period from childhood to adulthood. However, studies of the prevalence over time and implications on educational outcomes are still limited, especially regarding multiple pain symptoms. The present study material consists of questionnaire surveys, completed in 2000 and 2008, including two study populations of 9th grade adolescents aged 15 living in West Sweden (n = 20 877). Pain symptoms and demographic variables were based on self-reports from the questionnaires, and school grades were obtained from Statistics Sweden after the student had finished their 9th grade. Between 2000 and 2008, the prevalence of abdominal pain increased among Swedish adolescents (largest increase in girls); the prevalence of headache increased only in girls; the prevalence of pain in upper body decreased only in boys. School grades were significantly lower among those with headache or abdominal pain. Among students with low school grades (10th percentile) the estimated difference between those having any of the symptoms or none were -27 school grade units (95% confidence interval for girls (-27.8; -26.0), for boys (-27.6; -25.5). Both symptoms being present pronounced the association. Low parental education increased the negative effect of symptoms on school grades, most pronounced in the group with the lowest grades. In conclusion, identification of pain symptoms may improve academic achievements, especially in students with multiple symptoms and with parents having low education. Further intervention studies are need.
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| 8. |
- Holm, Mathias, 1969, et al.
(author)
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Incidence and prevalence of chronic bronchitis: impact of smoking and welding. The RHINE study.
- 2012
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In: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. - Paris, France : International Union Against Tuberculosis and Lung Disease. - 1815-7920 .- 1027-3719. ; 16:4, s. 553-7
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Journal article (peer-reviewed)abstract
- To investigate the prevalence and incidence rate of chronic bronchitis (CB) in relation to smoking habits and exposure to welding fumes in a general population sample.
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| 9. |
- Kim, Jeong-Lim, et al.
(author)
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Fish consumption and school grades in Swedish adolescents: a study of the large general population.
- 2010
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In: Acta Paediatrica. - 1651-2227. ; 99, s. 72-7
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Journal article (peer-reviewed)abstract
- AIM: To study the associations between fish intake and academic achievement as cognitive parameter among Swedish adolescents. METHODS: In 2000, a questionnaire including respiratory items, socioeconomic conditions and dietary information was mailed to all schoolchildren (n = 18 158), aged 15 and living in Västra Götaland region of Sweden. The questionnaire was returned by 10 837 subjects. One year later, the total school grades for each subject who had completed the questionnaire and who included their full personal identification number were obtained from the national registers. Multiple linear regression models were applied to evaluate the association between fish intake and academic grades among 9448 schoolchildren, while adjusting for potential confounders, e.g. parents' education. RESULTS: Grades were higher in subjects with fish consumption once a week compared with subjects with fish consumption of less than once a week (reference group) [increment in estimate 14.5, 95% confidence interval (CI) 11.8-17.1]. Grades were even higher in subjects with fish consumption of more than once a week compared with the reference group (increment in estimate 19.9, 95% CI 16.5-23.3). In the model stratified for parents' education, there were still higher grades among subjects with frequent fish intake in all educational strata (p < 0.01). CONCLUSION: Frequent fish intake among schoolchildren may provide benefits in terms of academic achievement.
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| 10. |
- Kim, Jeong-Lim, et al.
(author)
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Impact of occupational exposures on exacerbation of asthma: a population-based asthma cohort study.
- 2016
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In: BMC pulmonary medicine. - : Springer Science and Business Media LLC. - 1471-2466. ; 16:1
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Journal article (peer-reviewed)abstract
- Asthma is a prevalent chronic disease and occupation contributes to approximately 15% of cases among adults. However, there are still few studies on risk factors for work-exacerbated asthma. The current study investigated the association between asthma exacerbations and occupational exposures.The study comprised all currently working adults (n=1356) who reported ever asthma in prior population-based cohorts. All subjects completed a questionnaire about exposures, occupations and exacerbations of asthma. Exposure to high and low molecular weight agents, irritating agents and asthmagens were classified using the asthma-specific job exposure matrix for northern Europe (N-JEM). Severe exacerbation of asthma was defined as sought emergency care at a hospital, admitted to a hospital overnight, or made an urgent visit to a primary care physician or district medical office due to breathing problems during the last 12months. Moderate exacerbation was defined as both being not severe exacerbation and an additional visit to a primary care physician or district medical office, or had extra treatments with corticosteroid tablets. Mild exacerbation was defined as being neither severe nor moderate exacerbation, and increasing usage of inhaled corticosteroids. Multiple logistic regression was applied to investigate the association between exacerbation of asthma and occupational exposures while adjusting for potential confounders.Approximately 26% of the working asthmatics reported exacerbation, and more than two-thirds of them had moderate or severe exacerbation. From 23 to 49% of the asthmatics reported occupational exposure to a variety of different types of agents. Exposure to any gas, smoke or dust (OR 1.7[95 % CI 1.2-2.6]) was associated with severe exacerbation of asthma, as were organic dust (OR 1.7[1.2-2.5]), dampness and mold (OR 1.8[1.2-2.7]), cold conditions (OR 1.7[1.1-2.7]), and a physically strenuous job (OR 1.6[1.03-2.3]). Asthmagens and low molecular weight agents classified by the N-JEM were associated with mild exacerbation, with OR 1.6[1.1-2.5] and OR 2.2[1.1-4.4], respectively.Self-reported exposure to any gas, smoke or dust, organic dust, dampness and mold, cold conditions and physically strenuous work, and jobs handling low molecular weight agents were associated with exacerbation of asthma. Reduction of these occupational exposures may help to reduce exacerbation of asthma.
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